Clinical skills reflective report on clinical

Introduction

Clinical Skills Reflective Report

Student’s Name

Institutional Affiliation

Case Study: The Client with Mental Health Issues

As a social worker in any counseling service, different clients with different cases come for counseling, and as counselors, we offer help and support accordingly. Therefore, counseling is about building a strong relationship between the counselor and the client and empower them to attain education, mental wellness, and career goals. In counseling, the counselors opening process involves tone-setting or establishing of a good therapeutic relationship. The process is significant when it comes to interacting with the clients since it allows the counselor to be able to know the client, and vice versa. It is also very important to know the level of your client’s understanding (Tolan and Cameron, 2016). Therefore, in this case, as a counsellor you will be required to check their past and their current concerns. This will greatly help in working together with Lilly to come up with goals to be achieved and set favorable expectations. After understanding her, you will need to choose the appropriate counseling techniques through intervention. Explore the problem by learning more about the reasons as to why the Lilly is there for counseling. When it comes to creating a solution to any disorder, great emphasis should be placed on empowering the client to fashion their solution tailormade to suit their predicament because as the counselor, you cannot provide all solutions.

In counseling, there are important techniques that enhance the success of the session. Listening is a priceless skill in counseling and can be expressed in three different ways namely attending, active listening and verbal listening. Attending occurs when the counselor gives the client undivided attention by maintaining eye contact and nodding as you listen. Listening happens when you involve all your senses in listening, which is achieved through proper body language, use of eyes, heart, ears, and mouth (Nor, 2020). Lastly is verbal listening is enhanced by using proper verbal cues, such as affirming the client by using statements such as ‘go on’ just but to mention a few. This shows that you have (in this case Lilly’s) her attention, therefore, enhancing more exploration. Another important technique is asking questions in that they create and allows room for the counselor to know the client. Questions are therapeutic. Questions are governed by the tone that you will set which enhances a fluent rapport during the entire session. Some questions require a ‘yes or no’ answer, whereas some require exploration and reflection on the client’s verbal and nonverbal cues. Reflection also helps to tell the state the client is in by keenly observing their verbal and non-verbal cues. This can also be attained by affirmation, whereby affirming some of the client’s life choices, progress, and decisions will encourage her. As a counselor, it is important to show empathy to Lilly as this shows you can understand the situation she is in (Phakachandra et al., 2018). In addition, stay genuine to your words in all the counseling techniques and cues. Show respect to Lilly the client. This empathy encourages Lilly because she feels accepted just as she is. During the session, the counselor should only share personal information that is only advantageous to the therapy. This in most cases, enhances a good rapport between the counselor and the client.

Clinical Skills is that which is observed within the entire process of caring for a client or patient. They include all the skills needed in any interaction that happens between the doctor and the patient. In most cases, communication skills are also key in interaction with other health-related professionals attributed to patient care (Tawanwongsri and Phenwan, 2019). In most consultations happening between the doctor and the patient, several skills are effectively combined to give advanced skills. The consultation takes place through the patient presenting their issue.

Several other skills are incorporated along with the presentation—for instance, interview skills, explanations, decision making, and clinical reasoning. Clinical reasoning is an important skill as it guides the clinician through clinical interpretations, and evaluations initiated to gather information necessary for translation of the patient’s problem. This can only be achieved through repetitive practices and relied on for explicit assessment (Cooper and Wieckowski, 2017). Other important clinical skills include cultural awareness, which enhances complete centered patient care. There are cases where some of the cultural values and beliefs affect the client’s view of mental wellness and health. Therefore, it is upon the clinician dealing with such a kind of patient to understand and adjust to the patient’s preference to offer help accordingly. Also, professionalism before the client should be observed. This shows dedication as it encompasses a sense of responsibility, discipline, integrity, and respect. Attention to the details given by the patient is very core in exhibiting proper care. Therefore, one should put more focus on observing the verbal and nonverbal cues through active listening. Proper effective communication should be observed. How one communicates with the patient is of importance just as what they communicate.

Counseling is one of the best options for dealing with psychological issues, for instance, depression, suicidal thoughts, and anxiety. It is not only applicable to mental health-related issues but also behavioral and relationship problems. People should not be ashamed of talking about their issues. Counseling helps people deal with their issues to a point they embark on their normal lifestyles before the issue happened. It also helps them to become more empowered and even stronger than before. It helps people let go of the past and focus on the future without guilt attached. Counselling also focuses on offering opportunities to help people live a healthy and normal lifestyle (Erlina et al., 2018). It helps people navigate through serious life difficult situations, such as school stress, divorce, family issues, loss of a job, loss of a loved one, and chronic disease.

Clients with any thoughts of committing suicide are challenging even to most of the counselors. Suicide has been the most difficult situation that counselors face in their workplaces. This is because, during therapy, the counselor encounters different responses from the client that could include anger, fear, and at some point, professional incompetence. However, a counselor’s awareness of the factors associated with an individual suicidal risk is very important as it would help provide enough information when dealing with a suicidal client. Some clients claim that committing suicide is a favorable and sufficient option to deal with stress or any other overwhelming feeling. Therefore, in this case as the counsellor it is particularly important to ask Lilly about suicidal tendencies even though, at that time, she is not able to explore it further. However, how one asks those questions is very important and should be attended to in a sensitive manner. This will depend on where you carry out the therapy, the client’s age, the emotional capacity, and the level of understanding of the client and intellectual maturity (Phalachandra, 2018).

Lily is a 12-year-old girl who has been referred to me for counseling on suicidal thoughts. She has severally told some of her friends that she feels like dying, and at some point, when she is angry and frustrated, she comments like she is going to kill herself. Taking note of where the therapy is taking place is key. Therefore, with Lily, I met her in an office setting and with no time I created a rapport with her to enhance a good relationship. In most cases, during counseling, a counselor should have tissue rolls ready and water. In this case, it is appropriate to offer a glass of water to the client; therefore, it is important to ask her and be free. Assure her of privacy and confidentiality (Cooper, Briggs, and Bagshaw, 2018). This gives her the confidence to share with me and grants me the confidence to explore more about her suicidal thoughts. However, it is important to remind her that I must inform the appropriate authority if she tends to hurt herself or the people around her. With this, I give her the chance to explain what she is going through to make her suicidal thoughts. Therefore, I attentively listen to her. As the counselor, I focused more on exploring the suicidal thought to help Lilly realize the meaning of her thoughts to get to a point where she can support herself appropriately. Lilly says that she feels like killing herself when she is alone or feels like she has no one to talk to. Therefore, I ask her open-ended questions regarding when she started experiencing these suicidal thoughts. This will largely help in determining the immediacy of the risk. To encourage her to keep sharing with me, I keep telling her statements like ‘go on’ and ‘yes’ where necessary and showing empathy (Sale et. al, 2018). This shows her that I am paying attention to her and, therefore, sets me to explore more. This allows me to understand her past background to recent life. I keep affirming her of the progress she is making and repeating what she says to assure her that you understand and are listening.

It is important to tell the client to rate her suicidal intensity on a scale of 0-10 (Marshall et al., 2016). Lilly’s thoughts were high, but she has not acted on them. She says that she cannot have the audacity to kill herself. As the counselor, I have to affirm the decisions she has made before and on her love for the family, that she can do everything to ensure that she and the family go back to the life they had. She has a positive mindset. I ask her how that has affected her academic wise and in relating with her friend. I assure her that I understand what she feels. She tells me of her coping strategies and protective factors. When she is bored or such thoughts come to her, she watches movies or does coloring, which is her hobby. When she cannot use the strategies, it shows that she is unable to keep herself safe. And therefore, discussing the support she can get outside the therapy will be of help. Encouraging her to normalize sharing what she feels will greatly help her.

Towards the end of the session, I ask Lilly how she feels after sharing that, and the feedback is positive and looks forward to another meeting to be scheduled tentatively on a later date. It is ethical to appreciate her for opening up and sharing her insecurities. Lastly, in conforming to due diligence and best practices, counselors need to take active steps in ensuring that all the therapeutic processes are taken care of.

References

Cooper, L., Briggs, L., & Bagshaw, S. (2018). Postdisaster counselling: personal, professional, and ethical issues. Australian Social Work, 71(4), 430-443.

Cooper, L. D., & Wieckowski, A. T. (2017). A structured approach to reflective practice training in a clinical practicum. Training and Education in Professional Psychology, 11(4), 252

ErlinaYaumas, N., Syafril, S., Noor, N. M., Mahmud, Z., Umar, J., Wekke, I. S., & Rahayu, T. (2018). The Importance of Counselling Basic Skills for the Counsellors. International Journal of Pure and Applied Mathematics, 119(18), 1195-1207.

Marshall, E. A., Butler, K., Roche, T., Cumming, J., & Taknint, J. T. (2016). Refugee youth: A review of mental health counselling issues and practices. Canadian Psychology/psychologie canadienne, 57(4), 308.

Nor, M. Z. M. (2020). Counselling: What and How. In Counseling and Therapy. IntechOpen.

Phalachandra, B., Ravindran, V. S., Mallappa, Y., Vij, U., Pant, D., & Joshi, V. (2018). Unit-2 Understanding Counselling. IGNOU.

Sale, E., Hendricks, M., Weil, V., Miller, C., Perkins, S., & McCudden, S. (2018). Counseling on Access to Lethal Means (CALM): an evaluation of suicide prevention means restriction training program for mental health providers. Community mental health journal, 54(3), 293-301.

Tawanwongsri, W., & Phenwan, T. (2019). Reflective and feedback performances on Thai medical students’ patient history-taking skills. BMC medical education, 19(1), 141.

Tolan, J., & Cameron, R. (2016). Skills in person-centered counselling & psychotherapy. Sage.